Consumo de harina de trigo fortificada en Colombia y su asociación con anemia y ferritina sérica baja
DOI:
https://doi.org/10.17533/udea.penh.v21n2a03Palabras clave:
ferritina, hemoglobina, fortificación, harina de trigo, enriquecimiento, efectividad, evaluaciónResumen
Antecedentes: la fortificación obligatoria de harina de trigo en Colombia no se ha evaluado. Objetivo: examinar las asociaciones entre el consumo de harina y ferritina sérica baja (BSF) y la prevalencia de anemia. Materiales y métodos: se completó un análisis secundario de la Encuesta Nacional de la Situación Nutricional de 2005 (ENSIN) para 3988 niños de 2-4 años, 5669 escolares de 5-12 años y 2053 mujeres no embarazadas de 13-49 años. Se examinó la relación entre el consumo (cuartiles) de alimentos que contenían harina (ACHT) y la BSF y la anemia mediante análisis de ji al cuadrado y modelos de regresión logística. Resultados: en modelos ajustados, controlando por el estado socioeconómico, alimentos de origen animal y la ingesta de suplementos en las 24 horas anteriores, existía relación entre ACHT y la anemia en los preescolares, al comparar el cuartil más alto del consumo de ACHT con el cuartil más bajo (OR: 0,7; IC 95 %: 0,6-0,9). No se observó asociación entre ACHT y BFS en modelos ajustados. Conclusiones: en Colombia, el consumo de alimentos que contienen harina de trigo se asocia con niveles más bajos de anemia en preescolares.
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Food Fortification Initiative. Global Progress of Industrially Milled Cereal Grains. [Internet]. [Cited October 2018]. Available from: http://ffinetwork.org/global_progress/index.php
Pachón H, Spohrer R, Mei Z, & Serdula MK. Evidence of the effectiveness of flour fortification programs on iron status and anemia: a systematic review. Nutr Rev. 2015;73(11):780-95. DOI: 10.1093/nutrit/nuv037
WHO, FAO, UNICEF, GAIN, MI, & FFI. Recommendations on wheat and maize flour fortification. Meeting Report: Interim Consensus Statement. Geneva, World Health Organization, 2009. [Internet]. [Cited October 2018]. Available from: www.who.int/nutrition/publications/micro- nutrients/wheat_maize_fort.pdf
Forero de Saade TPE. (1996). Decreto Número 1994 de 1996. [Internet]. [Cited October 2018]. Available from: https://www.invima.gov.co/images/stories/aliementos/decreto_1944_1996.pdf
Hurrell R, Ranum P, De Pee S, Biebinger R, Hulthen L, Johnson Q, et al. Revised recommendations for iron fortification of wheat flour and an evaluation of the expected impact of Current national wheat flour fortification programs. Food and Nutr Bull. 2010;31(suppl1):S7-S21. DOI: 10.1177/15648265100311S102
Hurrell RF. Flour fortification as a strategy to prevent anaemia. Brit J Nutr. 2015;114(04),501-2. DOI: 10.1017/S0007114515002147
República de Colombia, Instituto Nacional de Vigilancia de Medicamentos y Alimentos INVIMA. Procedimiento Para Importacion de Productos Cuyo Ingrediente Principal es la Harina de Trigo. 2013. [Internet]. [Cited October 2018]. Disponible en: https://paginaweb.invima.gov.co/informacion-de-intres/alimentos-y-bebidas-info/4378-procedimiento-paraimportaci%C3%B3n-de-productos-cuyo-ingrediente-principal-es-la-harina-de-trigo.html
Ojeda G, Ordóñez M, Ochoa LH. Salud sexual y reproductiva. Resultados Encuesta Nacional de Demografía y Salud. Profamilia, ICBF, USAID, el Ministerio de la Protección Social MPS, UNFPA. 2005. Bogotá: Disponible en: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/Base%20de%20datos%20ENDS%202005%20informe.pdf
Profamilia, Ministerio de la Protección Social, ICBF. Encuesta nacional de la situación nutricional en Colombia ENSIN 2005. Bogotá: Instituto Colombiano de Bienestar Familiar; 2006. 440 pp. Disponible en: https://www.icbf.gov.co/sites/default/files/libro_2005.pdf
Kraemer K, Zimmermann MB. Nutritional Anemia. Base: Sight and Life Press Basel; 2007. 400 pp. Available from: http://ernaehrungsdenkwerkstatt.de/fileadmin/user_upload/EDWText/TextElemente/Ernaehrungswissenschaft/Naehrstoffe/nutritional_anemia_book.pdf
Dirren H, Logman MH, Barclay DV, Freire WB. Altitude correction for hemoglobin. Eur J Clin Nutr. 1994;48(9):625-32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8001519
Rothman KJ, Greenland S, Lash T. Modern Epidemiology. 3rd ed. Philidephia (PA): Lippincott Williams & Williams. 2005. 56-60 pp.
Vélez CE, Castaño E, Deutsch R. An Economic Interpretation of Colombia’s SISBEN: A Composite Welfare Index Derived from the Optimal Scaling Algorithm An Economic Interpretation of Colombia’s SISBEN : A Composite Household Welfare Index Derived from the Optimal Scaling Algorithm. 1998. Available from: http://idbdocs.iadb.org/wsdocs/getdocument.aspx?docnum=364066
Tazhibayev S, Dolmatova O, Ganiyeva G, Khairov K, Ospanova F, Oyunchimeg D, et al. Evaluation of the potential effectiveness of wheat flour and salt fortification programs in five Central Asian countries and Mongolia. Food and Nutr Bull. 2002;29(4):255-65. DOI: 10.1177/156482650802900402
Assunção MC, Santos IS, Barros AJ, Gigante DP, Victora CG. Flour fortification with iron has no impact on anaemia in urban Brazilian children. Public Health Nutr. 2012;15(10):1796-801. DOI: 10.1017/S1368980012003047
Sadighi J, Mohammad K, Sheikholeslam R, Amirkhani MA, Torabi P, Salehi F, et al. Anaemia control: Lessons from the flour fortification programme. Public Health. 2009;123(12):794-9. DOI:10.1016/J.PUHE.2009.09.024
Grimm KA, Sullivan KM, Alasfoor D, Parvanta I, Mohammed-Suleiman AJ, Kaur M, et al. Iron-fortified wheat flour and iron deficiency among women. Food and Nutr Bull. 2012;33(3):180-5. DOI: 10.1177/156482651203300302
Martorell R, Ascencio M, Tacsan L, Alfaro T, Young M F, Addo OY, et al. Effectiveness evaluation of the food fortification program of Costa Rica: impact on anemia prevalence and hemoglobin concentrations in women and children. Am J Clin Nutr. 2015;101(1):210-7. DOI: 10.3945/ajcn.114.097709
Layrisse M, Garcia-Casal MN, Mendez-Castellano H, Jimenez M, Olavarria C H, Chavez J, et al. Impact of fortification of flours with iron to reduce the prevalence of anemia and iron deficiency among schoolchildren in Caracas, Venezuela: A followup. Food and Nutr Bull. 2002;23(4):384-9. DOI: 10.1177/156482650202300412
Hund, L., Northrop-Clewes C, Nazario R, et al. A novel approach to evaluating the iron and folate status of women of reproductive age in Uzbekistan after 3 years of flour fortification with micronutrients. PLOS ONE. 2013; 8 (11):1-11. DOI: 10.1371/journal.pone.0079726
Schultz J, Vatucawaqa P. Impact of Iron Fortified Flour in Child Bearing Age (CBA) Women in Fiji. 2010 Report. Fiji: National Food and Nutrition Centre, UNICEF, WHO, Mnistry of health Shaping Fiji’s Health; 2012, 61 pp. Available from: http://www.ffinetwork.org/monitor/Documents/Fiji.pdf
Lofti M, Venkatesh MG, Merx RJHM, Naber-van den Heuvel P. Micronutrient Fortification of Foods Current practices, research, and opportunities. Ontario, Canadá: The Micronutrient Initiative, International Development Research Centre, International Agricultural Centre. 1996. 109 pp. Available from: https://idl-bnc-idrc.dspacedirect.org/bitstream/handle/10625/14002/104386.pdf?sequence=1
Andrew A, Attanasio O, Fitzsimons E, Rubio-Codina M. Why is multiple micronutrient powder ineffective at reducing anaemia among 12–24 month olds in Colombia? Evidence from a randomised controlled trial. SSM - Popul Health. 2016;2:95-104. DOI: 10.1016/J.SSMPH.2016.02.004
WHO. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva: WHO: 2011. 5 pp. Available from: https://apps.who.int/iris/bitstream/handle/10665/85839/WHO_NMH_NHD_MNM_11.1_eng.pdf?ua=1
WHO. Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations. Vitamin and Mineral Nutrition Information System. Geneva: WHO; 2011. 6 pp. Available from: http://www.who.int/vmnis/indicators/serum_ferritin.pdf
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